Friday, June 12, 2009

HIV, Porn and risk

This week, the Adult Industry Medical Healthcare Foundation (AIM) announced that an adult performer tested positive for HIV.

She was tested on June 4th, performed on June 5th and got a positive test result on June 6th. Her last test (negative) was on April 29th. The standard in the heterosexual part of the adult industry is to be tested every 30 days.

The LA Department of Health has released information citing a total of 22 cases of HIV among adult porn performers over the past five years.

Obviously, this has caused people to revisit the condom policy in adult films.

On the face of it, it seems simple. People can share disease when they have sex. If you work in a medical office, your work place is required to provide you with regular training on risk reduction and provide you with personal protective equipment. When I managed a health care clinic, we were required to wear gloves when performing activities that could expose us to body fluids, closed toe shoes at all times, and, if performing an activity in which we could be splashed, eye protection. Of course people who perform in porn should be required to wear condoms. Of course, it's a little more complicated.

Prior to 1998 performers provided negative HIV tests when they showed up for work. There was a man, named Marc Wallice who, after receiving a positive HIV test, chose to fake his test results and continue performing. He infected five women. As a result, the industry, lead by AIM introduced new policies.

They made an agreement that all testing would be done thru AIM. This made it significantly more difficult to fake test results. They also started using a different kind of HIV test, called a PCR-DNA test. Unlike the tests that are most commonly used, which can take up to six months from infection to produce a positive result, the PCR-DNA test can find a positive result as soon as 9-11 days after infection. Testing was required every 30 days. Performers were required to sign a blanket release to allow sharing of the test results. Test results were filed in a data base. Over the years, the data base developed and now, is accessible to the industry on the Internet (with appropriate confidentiality). In addition, people are tested for chlamydia and gonorrhea every 30 days, syphilis, genital exams and vaginal and anal pap smear are conducted every six months. New performers are encouraged to be tested for Hepatitis A, B and C and vaccinated for Hep A and B (there is no vaccine for Hep C)

Performers then choose if they want to use condoms.

In 2004 the industry shut down. Darren James, an industry performer, shot in Brazil, and returned to the states. He took an HIV test immediately after his return and continued to work. His next test came back positive. Within 24 hours, people with first and second generation exposures were on work quarantine. The industry shut down. At the end of the shut down, three women were identified as positive. One of the women had only been working in the industry for three months. One other performer also came up positive - her infection was not related to Darren James.

In the next three years, AIM identified four more people as HIV positive, none of them were infected in the work place. Each month, AIM tests 300-500 new performers. Between one to four are HIV positive and never make it to a set.

Of course, from all of the information that I can find, it seems that all of this applies only to the heterosexual part of the industry.

Nice, right?

But - all of this testing doesn't mean that condoms aren't a good idea. There's still time between a test and when someone shows up positive. And there are other diseases besides HIV.

Here's the reason that some women in straight porn don't want to use condoms. They are having vaginal or anal intercourse for prolonged periods of time And in those circumstances condoms can be irritating. Even non latex condoms - although those would be less irritating.

After the positive test results in 2004, some companies, including Vivid, started a condom mandatory policy. By 2007, Vivid had dropped the policy due to complaints from the talent. They are now condom optional. Currently, the only heterosexual company to require condom usage is Wicked. There are several gay companies that require condoms, including all ChiChi LaRue productions. But there is also a large barebacking (no condoms) portion of the gay industry. Which is concerning. HIV is most easily transmitted by receptive unprotected anal intercourse.

So - essentially, the vast majority of people in the industry are relying on regular testing to keep them safe. There are holes in the system. In this most recent case, the person who showed up positive worked with an out of date test. It's not clear why she was allowed to perform since her most recent test for which there were results was more than 30 days old.

The LA Health Department has announced several other positive test results - a total of 22 adult performers in the past five years. 10 of which are men who perform in the gay portion of the industry (which apparently doesn't use AIM).

Of course the question is - should the adult industry be regulated with laws instead of just the self-regulation they have been using? Or is what they are currently doing enough? The rates of transmission of HIV are extremely low. But clearly, it does happen.

There are problems with additional regulation. First, it will change how often some people are able to work. They will experience more regular wear and tear on their vaginas and asses with latex and poly condoms than with just skin on skin contact.

California law would need to be re-written. The easiest way to enforce a condom mandatory policy is by making the performers (most of whom are independent contractors) employees. This would move them into a category of law in which it is easier to enforce the use of personal protection equipment (like at a medical clinic). But, current law states that employers are not allowed to require an employee to take an HIV test. The existing regular testing is a critical part of keeping transmission low in the industry. Condoms fail. It would also introduce the question of using other latex barriers. Barriers like dental dams. I am sure the industry would protest that. Dental dams cover the pussy. And shots of the pussy are one of the mainstays of porn. Many directors won't even allow the Hitachi Magic Wand to be used because it covers too much of the pussy.

There is an element of danger anytime someone has sex. When we introduce money into the equation it changes things. There is an impetus on the side of the employer to provide a work place that is as safe as possible. Performers with big names have more choices about demanding condom usage. And even then, I know of cases in which people have been shamed or called out for asking to use a condom. I especially worry about the younger and newer performer. No one wants to seem like a kill joy. People want to appear that they are flexible team players. So that they are hired again. And can pay the rent. If condoms were a given, these more vulnerable performers would be protected.

As much as I empathize with the performers who are concerned about vaginal or rectal wear (for lack of a better word), I feel that it is the responsibility of the industry to take care of the most vulnerable. And the only way to do that is to require condoms and to change the number of days between tests from 30 to 15. Nothing will eliminate the possibility of the spread of HIV. But, we must make it as difficult as possible.

So, please, treat performers with the respect that is shown to people in all other industries. Some performers will complain. I saw what requiring gloves did to nurses who were used to palpating veins bare handed. But you know what? They adapted. And they are safer because of it.

The industry should make the move before they are required to by the state. And by industry, I mean the whole industry. Including the gay sector. Frankly, with the rising prevalence of HIV in the young gay community, gay bare backing videos are the equivalent of snuff films.

It's 2008. Condoms are a must. Even for professionals. Especially for professionals.

2 comments:

"Within 24 hours, people with first and second generation exposures were on work quarantine. "

This is not true. On April 14, 24 hours after the announcement that Darren James was tested positive for HIV, AVN published the following:

While the first-generation has been identified and quarantined, and AIM is rapidly creating a quarantine list for the second-generation, there is no doubt that there is already a third- and even fourth-generation in the outbreak.

The third- and fourth-generation is not being quarantined; AIM simply can’t track down that many people fast enough.

Thus we recommend that all adult companies cease production, or at the minimum shoot condom-only productions, until all women who have worked with Darren James since his last negative test, known as the “first-generation” have cleared. That will be on June 8, 2004.

What actually happened is that on May 11 the "quarantine" which was being wildly ignored, was called off.